Agency Information Collection (Request for and Authorization to Release Medical Records or Health Information) Activities under OMB Review, 59348-59349 [E9-27588]

Download as PDF 59348 Federal Register / Vol. 74, No. 220 / Tuesday, November 17, 2009 / Notices unless it displays a currently valid OMB control number. The Federal Register Notice with a 60-day comment period soliciting comments on this collection of information was published on September 9, 2009, at page 46485. Affected Public: Individuals or households. Estimated Total Annual Burden: 125 hours. Estimated Average Burden Per Respondent: 5 minutes. Frequency of Response: Bi-Annually. Estimated Number of Respondents: 1,500. Dated: November 12, 2009. By direction of the Secretary. Denise McLamb, Program Analyst, Enterprise Records Service. [FR Doc. E9–27586 Filed 11–16–09; 8:45 am] BILLING CODE 8320–01–P DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900–New (10–0473)] Agency Information Collection (Millennium Bill Emergency Care Provider Satisfaction Survey) Activities Under OMB Review AGENCY: Veterans Health Administration, Department of Veterans Affairs. ACTION: Notice. SUMMARY: In compliance with the Paperwork Reduction Act (PRA) of 1995 (44 U.S.C. 3501–3521), this notice announces that the Veterans Health Administration (VHA), Department of Veterans Affairs, will submit the collection of information abstracted below to the Office of Management and Budget (OMB) for review and comment. The PRA submission describes the nature of the information collection and its expected cost and burden and includes the actual data collection instrument. Comments must be submitted on or before December 17, 2009. ADDRESSES: Submit written comments on the collection of information through www.Regulations.gov; or to VA’s OMB Desk Officer, OMB Human Resources and Housing Branch, New Executive Office Building, Room 10235, Washington, DC 20503, (202) 395–7316. Please refer to ‘‘OMB Control No. 2900– New (10–0473)’’ in any correspondence. FOR FURTHER INFORMATION CONTACT: Denise McLamb, Enterprise Records Service (005R1B), Department of Veterans Affairs, 810 Vermont Avenue, NW., Washington, DC 20420, (202) 461– mstockstill on DSKH9S0YB1PROD with NOTICES DATES: VerDate Nov<24>2008 20:50 Nov 16, 2009 Jkt 220001 7485, fax (202) 273–0443 or e-mail denise.mclamb@mail.va.gov. Please refer to ‘‘OMB Control No. 2900–New (10–0473).’’ SUPPLEMENTARY INFORMATION: Title: Millennium Bill Emergency Care Provider Satisfaction Survey, VA Form 10–0473. OMB Control Number: 2900–New (10–0473). Type of Review: New collection. Abstract: VA Form 10–0473 will be used to survey non-VA healthcare providers who participate in the Millennium Bill Fee Reimbursement/ Purchased Care program on their satisfaction with VHA’s claims processing services. VA will use the data collected to improve the claims processing program. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. The Federal Register Notice with a 60-day comment period soliciting comments on this collection of information was published on September 9, 2009, at pages 46485– 46486. Affected Public: Individuals or households. Estimated Annual Burden: 9 hours. Estimated Average Burden per Respondent: 5 minutes. Frequency of Response: Annually. Estimated Number of Respondents: 110. Dated: November 12, 2009. By direction of the Secretary. Denise McLamb, Program Analyst, Enterprise Records Service. [FR Doc. E9–27587 Filed 11–16–09; 8:45 am] BILLING CODE 8320–01–P DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900–0260] Agency Information Collection (Request for and Authorization to Release Medical Records or Health Information) Activities under OMB Review AGENCY: Veterans Health Administration, Department of Veterans Affairs. ACTION: Notice. SUMMARY: In compliance with the Paperwork Reduction Act (PRA) of 1995 (44 U.S.C. 3501–3521), this notice announces that the Veterans Health Administration (VHA), Department of Veterans Affairs, will submit the collection of information abstracted PO 00000 Frm 00236 Fmt 4703 Sfmt 4703 below to the Office of Management and Budget (OMB) for review and comment. The PRA submission describes the nature of the information collection and its expected cost and burden and includes the actual data collection instrument. DATES: Comments must be submitted on or before December 17, 2009. ADDRESSES: Submit written comments on the collection of information through www.Regulations.gov or to VA’s OMB Desk Officer, OMB Human Resources and Housing Branch, New Executive Office Building, Room 10235, Washington, DC 20503, (202) 395–7316. Please refer to ‘‘OMB Control No. 2900– 0260’’ in any correspondence. FOR FURTHER INFORMATION CONTACT: Denise McLamb, Enterprise Records Service (005R1B), Department of Veterans Affairs, 810 Vermont Avenue, NW., Washington, DC 20420, (202) 461– 7485, fax (202) 273–0443 or e-mail denise.mclamb@mail.va.gov. Please refer to ‘‘OMB Control No. 2900–0260.’’ SUPPLEMENTAL INFORMATION: Titles: a. Request for and Authorization to Release Medical Records or Health Information, VA Form 10–5345. b. Individual’s Request for a Copy of their Own Health Information, VA Form 10–5345a. c. My HealtheVet (MHV)— Individuals’ Request for a Copy of Their Own Health Information, VA Form 10– 5345a–MHV. OMB Control Number: 2900–0260. Type of Review: Revision of a currently approved collection. Abstracts: a. VA Form 10–5345 is used to obtain a written consent from patients before information concerning his or her treatment for alcoholism or alcohol abuse, drug abuse, sickle cell anemia, or infection with the human immunodeficiency virus (HIV) can be disclosed to private insurance companies, physicians and other third parties. b. Patients complete VA Form 10– 5345a to request a copy of their health information maintained at Department of Veterans Affairs. c. VA Form 10–5345a–MHV is completed by individuals requesting their health information electronically through My HealtheVet. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. The Federal Register Notice with a 60-day comment period soliciting comments on this collection of information was published on E:\FR\FM\17NON1.SGM 17NON1 Federal Register / Vol. 74, No. 220 / Tuesday, November 17, 2009 / Notices September 9, 2009 at pages 46484– 46485. Affected Public: Individuals or households. Estimated Total Annual Burden a. VA Form 10–5345—15,000 hours. b. VA Form 10–5345a—15,000 hours. c. VA Form 10–5345a–MVH—35,000 hours. Estimated Average Burden Per Respondent: 3 minutes. Frequency of Response: On occasion. Estimated Number of Respondents: a. VA Form 10–5345—300,000. b. VA Form 10–5345a—300,000. c. VA Form 10–5345a–MVH— 700,000. Dated: November 12, 2009. By direction of the Secretary. Denise McLamb, Program Analyst, Enterprise Records Service. [FR Doc. E9–27588 Filed 11–16–09; 8:45 am] BILLING CODE 8320–01–P DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900–New (21–0844)] Proposed Information Collection (Certification of Fully Developed Claim) Activity: Comment Request mstockstill on DSKH9S0YB1PROD with NOTICES AGENCY: Veterans Benefits Administration, Department of Veterans Affairs. ACTION: Notice. SUMMARY: The Veterans Benefits Administration (VBA), Department of Veterans Affairs (VA), is announcing an opportunity for public comment on the proposed collection of certain information by the agency. Under the Paperwork Reduction Act (PRA) of 1995, Federal agencies are required to publish notice in the Federal Register concerning each proposed collection of information, including each proposed existing collection in use without an OMB Control Number and allow 60 days for public comment in response to the notice. This notice solicits comments on information needed to process compensation and pension claims within 90 days after receipt of the claim. DATES: Written comments and recommendations on the proposed collection of information should be received on or before January 19, 2010. ADDRESSES: Submit written comments on the collection of information through the Federal Docket Management System (FDMS) at www.Regulations.gov; or to Nancy J. Kessinger, Veterans Benefits Administration (20M35), Department of Veterans Affairs, 810 Vermont Avenue, VerDate Nov<24>2008 20:50 Nov 16, 2009 Jkt 220001 NW., Washington, DC 20420; or e-mail nancy.kessinger@va.gov. Please refer to ‘‘OMB Control No. 2900-New (21– 0844)’’ in any correspondence. During the comment period, comments may be viewed online at FDMS. FOR FURTHER INFORMATION CONTACT: Nancy J. Kessinger at (202) 461–9769 or FAX (202) 275–5947. SUPPLEMENTARY INFORMATION: Under the PRA of 1995 (Pub. L. 104–13; 44 U.S.C. 3501–3521), Federal agencies must obtain approval from the Office of Management and Budget (OMB) for each collection of information they conduct or sponsor. This request for comment is being made pursuant to Section 3506(c)(2)(A) of the PRA. With respect to the following collection of information, VBA invites comments on: (1) Whether the proposed collection of information is necessary for the proper performance of VBA’s functions, including whether the information will have practical utility; (2) the accuracy of VBA’s estimate of the burden of the proposed collection of information; (3) ways to enhance the quality, utility, and clarity of the information to be collected; and (4) ways to minimize the burden of the collection of information on respondents, including through the use of automated collection techniques or the use of other forms of information technology. Title: Certification of Fully Developed Claim, VA Form 21–0844. OMB Control Number: 2900-New (21– 0844). Type of Review: Existing collection in use without an OMB Control Number. Abstract: VA Form 21–0844 is used to process a claim within 90 days after receipt by a claimant or their representative. Claimants or their representative are required to sign and date the certification, certifying as of the signed date, no additional information or evidence is available or needs to be submitted in order to adjudicate the claim. Affected Public: Individuals and Households. Estimated Annual Burden: 132 hours. Estimated Average Burden Per Respondent: 5 minutes. Frequency of Response: On Occasion. Estimated Number of Respondents: 1,584. Dated: November 12, 2009. By direction of the Secretary. Denise McLamb, Program Analyst, Enterprise Records Service. [FR Doc. E9–27589 Filed 11–16–09; 8:45 am] BILLING CODE 8320–01–P PO 00000 Frm 00237 Fmt 4703 Sfmt 4703 59349 DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900–0358] Agency Information Collection (Supplemental Information for Change of Program or Reenrollment After Unsatisfactory Attendance, Conduct or Progress) Activities Under OMB Review AGENCY: Veterans Benefits Administration, Department of Veterans Affairs. ACTION: Notice. SUMMARY: In compliance with the Paperwork Reduction Act (PRA) of 1995 (44 U.S.C. 3501–21), this notice announces that the Veterans Benefits Administration (VBA), Department of Veterans Affairs, will submit the collection of information abstracted below to the Office of Management and Budget (OMB) for review and comment. The PRA submission describes the nature of the information collection and its expected cost and burden; it includes the actual data collection instrument. DATES: Comments must be submitted on or before December 17, 2009. ADDRESSES: Submit written comments on the collection of information through www.Regulations.gov; or to VA’s OMB Desk Officer, OMB Human Resources and Housing Branch, New Executive Office Building, Room 10235, Washington, DC 20503, (202) 395–7316. Please refer to ‘‘OMB Control No. 2900– 0358’’ in any correspondence. FOR FURTHER INFORMATION CONTACT: Denise McLamb, Enterprise Records Service (005R1B), Department of Veterans Affairs, 810 Vermont Avenue, NW., Washington, DC 20420, (202) 461– 7485, fax (202) 273–0443 or e-mail denise.mclamb@mail.va.gov. Please refer to ‘‘OMB Control No. 2900–0358.’’ SUPPLEMENTAL INFORMATION: Title: Supplemental Information for Change of Program or Reenrollment after Unsatisfactory Attendance, Conduct or Progress, VA Form 22–8873. OMB Control Number: 2900–0358. Type of Review: Extension of a currently approved collection. Abstract: Veterans and other eligible persons may change their program of education under conditions prescribed by Title 38 U.S.C., Section 3691. A claimant can normally make one change of program without VA approval. VA approval is required if the claimant makes any additional change of program. Before VA can approve benefits for a second or subsequent change of program, VA must first determine that the new program is E:\FR\FM\17NON1.SGM 17NON1

Agencies

[Federal Register Volume 74, Number 220 (Tuesday, November 17, 2009)]
[Notices]
[Pages 59348-59349]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E9-27588]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0260]


Agency Information Collection (Request for and Authorization to 
Release Medical Records or Health Information) Activities under OMB 
Review

AGENCY: Veterans Health Administration, Department of Veterans Affairs.

ACTION: Notice.

-----------------------------------------------------------------------

SUMMARY: In compliance with the Paperwork Reduction Act (PRA) of 1995 
(44 U.S.C. 3501-3521), this notice announces that the Veterans Health 
Administration (VHA), Department of Veterans Affairs, will submit the 
collection of information abstracted below to the Office of Management 
and Budget (OMB) for review and comment. The PRA submission describes 
the nature of the information collection and its expected cost and 
burden and includes the actual data collection instrument.

DATES: Comments must be submitted on or before December 17, 2009.

ADDRESSES: Submit written comments on the collection of information 
through www.Regulations.gov or to VA's OMB Desk Officer, OMB Human 
Resources and Housing Branch, New Executive Office Building, Room 
10235, Washington, DC 20503, (202) 395-7316. Please refer to ``OMB 
Control No. 2900-0260'' in any correspondence.

FOR FURTHER INFORMATION CONTACT: Denise McLamb, Enterprise Records 
Service (005R1B), Department of Veterans Affairs, 810 Vermont Avenue, 
NW., Washington, DC 20420, (202) 461-7485, fax (202) 273-0443 or e-mail 
denise.mclamb@mail.va.gov. Please refer to ``OMB Control No. 2900-
0260.''

SUPPLEMENTAL INFORMATION:
    Titles:
    a. Request for and Authorization to Release Medical Records or 
Health Information, VA Form 10-5345.
    b. Individual's Request for a Copy of their Own Health Information, 
VA Form 10-5345a.
    c. My HealtheVet (MHV)--Individuals' Request for a Copy of Their 
Own Health Information, VA Form 10-5345a-MHV.
    OMB Control Number: 2900-0260.
    Type of Review: Revision of a currently approved collection.
    Abstracts:
    a. VA Form 10-5345 is used to obtain a written consent from 
patients before information concerning his or her treatment for 
alcoholism or alcohol abuse, drug abuse, sickle cell anemia, or 
infection with the human immunodeficiency virus (HIV) can be disclosed 
to private insurance companies, physicians and other third parties.
    b. Patients complete VA Form 10-5345a to request a copy of their 
health information maintained at Department of Veterans Affairs.
    c. VA Form 10-5345a-MHV is completed by individuals requesting 
their health information electronically through My HealtheVet.
    An agency may not conduct or sponsor, and a person is not required 
to respond to a collection of information unless it displays a 
currently valid OMB control number. The Federal Register Notice with a 
60-day comment period soliciting comments on this collection of 
information was published on

[[Page 59349]]

September 9, 2009 at pages 46484-46485.
    Affected Public: Individuals or households.
    Estimated Total Annual Burden
    a. VA Form 10-5345--15,000 hours.
    b. VA Form 10-5345a--15,000 hours.
    c. VA Form 10-5345a-MVH--35,000 hours.
    Estimated Average Burden Per Respondent: 3 minutes.
    Frequency of Response: On occasion.
    Estimated Number of Respondents:
    a. VA Form 10-5345--300,000.
    b. VA Form 10-5345a--300,000.
    c. VA Form 10-5345a-MVH--700,000.

    Dated: November 12, 2009.

    By direction of the Secretary.

Denise McLamb,
Program Analyst, Enterprise Records Service.
[FR Doc. E9-27588 Filed 11-16-09; 8:45 am]
BILLING CODE 8320-01-P
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